Sabrina Scilletta, Nicoletta Miano, Maurizio Di Marco, Marco Musmeci, Salvatore Carasi, Stefania Capuccio, Claudia Pistritto, Caterina Ippolito, Mariapaola Tiralongo, Antonio Ricci, Maria Chiara Papa, Giosiana Bosco, Francesco Di Giacomo Barbagallo, Antonino Di Pino, Salvatore Piro, Roberto Scicali
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引用次数: 0
Abstract
Background: Familial hypercholesterolemia (FH) is characterized by elevated LDL cholesterol (LDL-C) levels that promote atherosclerosis progression. Limited data exist on the link between elevated LDL-C and cognitive impairment. The aim of this study was to assess the prevalence of cognitive impairment in FH subjects and its association with subclinical vascular damage.
Methods: In this cross-sectional observational study, we evaluated 253 genetically confirmed FH subjects aged between 18 and 75 years and without previous documented cognitive disorders. Clinical evaluation, biochemical analyses and vascular profile assessment were obtained from all subjects. Cognitive function was assessed using the Short Blessed Test (SBT). Participants were stratified into two groups according to SBT: normal cognition (NC) group (n = 202) and impaired cognition (IC) group (n = 51).
Results: The IC group was older and had higher prevalence of hypertension than the NC group. Dutch Lipid Clinical Network (DLCN) score at diagnosis was higher in the IC group than the NC group. Pulse wave velocity (PWV) and intima-media thickness (IMT) were significantly elevated in the IC group than the NC group (PWV: 8.64±0.43 vs 7.24±0.13 m/s, p = 0.0001; IMT: 0.78±0.02 vs 0.68±0.01 mm, p = 0.0003). Logistic regression showed that cognitive impairment was independently associated with increased PWV (OR 1.32 [1.06-1.66], p = 0.012).
Conclusions: FH subjects with cognitive impairment exhibited increased PWV and IMT. These findings suggest that subclinical vascular damage may independently contribute to the cognitive decline in FH subjects.
背景：家族性高胆固醇血症（FH）的特征是低密度脂蛋白胆固醇（LDL- c）水平升高，从而促进动脉粥样硬化的进展。关于LDL-C升高与认知障碍之间的联系的数据有限。本研究的目的是评估FH受试者中认知障碍的患病率及其与亚临床血管损伤的关系。方法：在这项横断面观察性研究中，我们评估了253名基因证实的FH患者，年龄在18至75岁之间，既往无认知障碍记录。所有受试者均进行临床评估、生化分析和血管特征评估。认知功能评估采用短祝福测试（SBT）。按SBT分为认知正常组（NC） 202例和认知障碍组（IC） 51例。结果：IC组年龄大，高血压患病率高于NC组。IC组诊断时荷兰脂质临床网络（DLCN）评分高于NC组。IC组脉搏波速度（PWV）和内膜-中膜厚度（IMT）显著高于NC组（PWV: 8.64±0.43 vs 7.24±0.13 m/s, p = 0.0001; IMT: 0.78±0.02 vs 0.68±0.01 mm, p = 0.0003）。Logistic回归分析显示，认知障碍与PWV升高独立相关（OR 1.32 [1.06-1.66], p = 0.012）。结论：伴有认知障碍的FH患者表现出PWV和IMT升高。这些发现表明，亚临床血管损伤可能是FH患者认知能力下降的独立原因。
期刊介绍：
The European Journal of Internal Medicine serves as the official journal of the European Federation of Internal Medicine and is the primary scientific reference for European academic and non-academic internists. It is dedicated to advancing science and practice in internal medicine across Europe. The journal publishes original articles, editorials, reviews, internal medicine flashcards, and other relevant information in the field. Both translational medicine and clinical studies are emphasized. EJIM aspires to be a leading platform for excellent clinical studies, with a focus on enhancing the quality of healthcare in European hospitals.
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